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Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study

BMJ 2011; 343 doi: (Published 11 October 2011) Cite this as: BMJ 2011;343:d5621

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  1. Jennifer Neuman, instructor1,
  2. Deborah Korenstein, associate professor2,
  3. Joseph S Ross, assistant professor3,
  4. Salomeh Keyhani, assistant adjunct professor45
  1. 1Department of Preventive Medicine, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1057, New York, NY 10029, USA
  2. 2Department of Medicine, Mount Sinai School of Medicine, New York
  3. 3Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06520-8093, USA
  4. 4Division of General Internal Medicine, University of California at San Francisco, San Francisco, CA, USA
  5. 5HSR&D Research Enhancement Award Program, VA Medical Center, 4150 Clement Street, San Francisco, CA 94121
  1. Correspondence to: J Neuman neuman.jennifer{at}
  • Accepted 10 August 2011


Objective To determine the prevalence of financial conflicts of interest among members of panels producing clinical practice guidelines on screening, treatment, or both for hyperlipidaemia or diabetes.

Design Cross sectional study.

Setting Relevant guidelines published by national organisations in the United States and Canada between 2000 and 2010.

Participants Members of guideline panels.

Main outcome measures Prevalence of financial conflicts of interest among members of guideline panels and chairs of panels.

Results Fourteen guidelines met our search criteria, of which five had no accompanying declaration of conflicts of interest by panel members. 288 panel members had participated in the guideline development process. Among the 288 panel members, 138 (48%) reported conflicts of interest at the time of the publication of the guideline and 150 (52%) either stated that they had no such conflicts or did not have an opportunity to declare any. Among 73 panellists who formally declared no conflicts, 8 (11%) were found to have one or more. Twelve of the 14 guideline panels evaluated identified chairs, among whom six had financial conflicts of interest. Overall, 150 (52%) panel members had conflicts, of which 138 were declared and 12 were undeclared. Panel members from government sponsored guidelines were less likely to have conflicts of interest compared with guidelines sponsored by non-government sources (15/92 (16%) v 135/196 (69%); P<0.001).

Conclusions The prevalence of financial conflicts of interest and their under-reporting by members of panels producing clinical practice guidelines on hyperlipidaemia or diabetes was high, and a relatively high proportion of guidelines did not have public disclosure of conflicts of interest. Organisations that produce guidelines should minimise conflicts of interest among panel members to ensure the credibility and evidence based nature of the guidelines' content.


  • Contributors: JN and SK conceived the study. JN, SK, JSR, and DK designed the study. JN collected the data. SK verified the data. JN and SK analysed and interpreted the data. JN and SK wrote the manuscript. All authors read, revised, and approved the final manuscript. JN is the guarantor.

  • Funding: This project was not directly supported by any research funds. SK is funded by a Veterans’ Administration HSR&D career development award. JSR is supported by the National Institute on Aging (K08 AG032886) and by the American Federation of Aging Research through the Paul B Beeson Career Development Award Program.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at (available on request from the corresponding author) and declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: Not needed.

  • Data sharing: All data on members of guideline panels are publicly available. Dataset available from corresponding author on request.

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